ABSTRACT
The principal objective of any health care service is to achieve the best possible levels of personal service and clinical outcome, both individually and collectively, within the available resources. Traditionally health care professionals have tended to work as individuals doing the best, as they saw it, for individual patients. This is increasingly recognized as inappropriate and inefficient; teamwork often delivers better care. However the teams needed to carry out a heart transplant or manage a prostatectomy is very different from those needed for diabetes care, asthma, rheumatoid arthritis or inflammatory bowel disease, for example, in which the necessary personnel are both multidisciplinary and distributed between primary and secondary health care sectors and between specialist sectors. This chapter describes some arrangements that are proving valuable in managing such services and which extend teamwork across traditional organizational and professional boundaries towards the concept of integrated care rather than simple sharing between functionally unaltered units.
